#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Dynamics of the GCS, NSE and S100B Serum Levels and the Morphology of the Expansive Contussion in Head Injury Patients


Authors: D. Vajtr 1,3;  R. Průša 1;  J. Kukačka 1;  L. Houšťava 2;  F. Šámal 2;  J. Pachl 4;  J. Pažout 4
Authors‘ workplace: Ústav klinické biochemie a patobiochemie 2. LF UK a FN Motol, Praha 1;  Neurochirurgická klinika 3. LF UK a FNKV, Praha 2;  Ústav soudního lékařství a toxikologie 1. LF UK a VFN, Praha 3;  Klinika anesteziologie a resuscitace 3. LF UK a FNKV, Praha 4
Published in: Cesk Slov Neurol N 2007; 70/103(5): 515-520
Category: Original Paper

Práce je podporována grantem IGA MZ, reg.č. NR/8793-3/2006.

Overview

Introduction.
Laboratory diagnose of brain contussions is based on monitoring of proteins released to circulation (such as neuron specific enolasis (NSE) and S100B protein) from affected tissues. Morphological investigation of biopsy speciments proved focal changes of brain.

Methods.
The group (n = 20) of patients with focal traumatic brain injury was investigated. In 9 patients was found improvement of Glasgow coma score (GCS) up to 13-15 points during 10 days after admission (group I) and 11 patients had value of GCS less than 13 (group II).

Results.
We found the decrease of value of NSE and S100 b protein in group of all patients with focal brain injury during 10 days of hospitalisation. In 5 patients who died we observed the increase of NSE and S100B protein values on the. 2.-3. day. Patients with improvement of clinical status and GCS up to 15 points during 10 days of hospitalisation (group I) had lower value of NSE (33.53 vs 61.76 μg/l, p < 0.05) and S100B protein (0.61 vs 4.45 μg/l, p 0.05) 1-3 days after admission compared to values of group II. A morphological investigation demonstrated no damage of nucleolus of glial and ganglial cells, and pericytes digested the foregin proteins. Immuno-histochemical investigation proved diffuse positivity of anti-NSE, and CD68 antibody reacted around vessels microenvironment.

Conclusion.
Monitoring of serum levels of NSE and S100B is convenient and complementary investigation for monitoring of patients with TBI.

Key words:
contusion – Glasgow Coma Score (GCS) - neuron specific enolasis – S100B protein – electron microscopy – immunohistochemistry


Sources

1. Gennarelli TA. Mechanisms of brain injury. J Emerg Med 1993; 11(Suppl 1): 5-11.

2. Castejon OJ, Acurero G. Traumatic axolemmal and cytoskeletal derangement in myelinated axons of human oedematous cerebral cortex and loss of consciousness. An electron microscopic study using cortical biopsies. J Submicrosc Cytol Pathol 2004; 36: 285-293.

3. Castejon OJ. Astrocyte subtypes in the gray matter of injured human cerebral cortex: a transmission electron microscope study. Brain Inj 1999; 13: 291-304.

4. Vajtr D, Průša R, Houšťava L, Šámal F, Kukačka J, Pachl J. Biochemical and immunohistochemical markers of brain injury. Soud Lek 2006; 51: 36-41.

5. Pleines UE, Morganti-Kossmann MC, Rancan M, Joller H, Trentz O, Kossmann T. S-100 beta reflects the extent of injury and outcome, whereas neuronal specific enolase is a better indicator of neuroinflammation in patients with severe traumatic brain injury. J Neurotrauma 2001; 18: 491-498.

6. Woertgen C, Rothoerl RD, Holzschuh M, Metz C, Brawanski A. Comparison of serial S-100 and NSE serum measurements after severe head injury. Acta Neurochir (Wien) 1997; 139: 1161-1164.

7. Woertgen C, Rothoerl RD, Brawanski A. Time profile of neuron specific enolase serum levels after experimental brain injury in rat. Acta Neurochir Suppl 2000; 76: 371-373.

8. Vos PE, Lamers KJ, Hendriks JC, van Haaren M, Beems T, Zimmerman C et al. Glial and neuronal proteins in serum predict outcome after severe traumatic brain injury. Neurology 2004; 62: 1303-1310.

9. Royd JA, Davies-Jones GAB, Lewtas NA. Enolase isoenzymes in the cerebrospinal fluid of patients with diseases of the nervous systém. J Neurol Neurosurg Psychiatry 1983, 46: 1031-1036.

10. Yamazaki Y, Yada K, Morii S, Kitahara T, Ohwada T. Diagnostic significance of serum neuron-specific enolase and myelin basic protein assay in patients with acute head injury. Surg Neurol 1995; 43: 267-270.

11. Unden J, Bellner J, Reinstrup P, Romner B. Serial S100B levels before, during and after cerebral herniation. Br J Neurosurg 2004; 18: 277-280.

12. Herrmann M, Jost S, Kutz S, Ebert AD, Kratz T, Wunderlich MT et al. Temporal profile of release of neurobiochemical markers of brain damage after traumatic brain injury is associated with intracranial pathology as demonstrated in cranial computerized tomography. J Neurotrauma 2000; 17: 113-122.

13. Herrmann M, N Curio, S Jost. Release of biochemical markers of damage to neuronal and glial brain tissue is associated with short and long term neuropsychological outcome after tramatic brain injury. J Neurol Neurosurg Psychiatry 2001, 70: 95-100.

14. Castejon OJ, de Castejon HV. Structural patterns of injured mitochondria in human oedematous cerebral cortex. Brain Inj 2004; 18:1107-1126.

15. Green DR, Reed JC. Mitochondria and apoptosis. Science 1998; 281: 1309.

16. Huang FP, Xi G, Keep RF., Hua Y, Nemoianu A, Hoff JT. Brain edema after experimental intracerebral hemorrhage: role of hemoglobin degradation products. J Neurosurg 2002; 96: 287–293.

17. Siesjo BK, Agardh CD, Bengstsson F. Free radicals and brain damage. Cerebrovasc Brain Metab Rev 1989; 1: 165–211.

18. Oehmichen M. Is traumatic axonal injury (AI) associated with an early microglial activation? Application of a double-labeling technique for simultaneous detection of microglia and AI. Acta Neuropathol 1999; 97: 491-494.

19. Castejon OJ, Arismendi GJ. Nerve cell nuclear and nucleolar abnormalities in the human oedematous cerebral cortex. An electron microscopic study using cortical biopsies. J Submicrosc Cytol Pathol 2004; 36: 273-283.

20. Vaz R, Sarmento A, Borges N, Cruz C, Azevedo I. Ultrastructural study of brain microvessels in patients with traumatic cerebral contusions. Acta Neurochir (Wien) 1997; 139: 215-220.

21. Kukacka J,Vajtr D, Huska D, Prusa R, Houstava L, Samal F et al. Blood metallothionein, neuron specific enolase, and protein S100B in patients with traumatic brain injury. Neuro Endocrinol Lett 2006; 27(Suppl 2): 116-120.Prusa R, Vajtr D, Kukacka J, Houstava L, Samal F, Kracmarova A et al. Gene Expression Profile and Serum Levels of NSE and S100b Protein in Patients with Traumatic Brain Injury during 10 Days of Hospitalization. Mol Biol Cell 2006; 17(Suppl): abstract 1340/B634 (CD-ROM).

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 5

2007 Issue 5

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#